Kaouk Jihad, Bertolo Riccardo, Eltemamy Mohamed, Garisto Juan
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.
Urology. 2019 Feb;124:309. doi: 10.1016/j.urology.2018.10.025. Epub 2018 Oct 24.
To describe the first clinical experience with the novel purpose-built single-port robotic platform after Food Drug Administration approval.
Two male patients diagnosed with prostate cancer amenable of radical prostatectomy underwent single-port robot-assisted radical prostatectomy with bilateral pelvic lymph-nodes dissection performed by using the da Vinci SP Surgical System (Intuitive Surgical, Sunnyvale, CA). The surgeries were completed through a 2.5-cm periumbilical incision through which a GelPOINT Mini advanced access platform (Applied Medical, Rancho Santa Margarita, CA) and the dedicated 25-mm multichannel port accommodating a 12 × 10 mm oval articulating robotic camera, three 6-mm double-jointed articulating robotic instruments and a 6-mm accessory laparoscopic instrument were placed. One port for the assistant was placed at the level of the para-rectal line, at the planned final site for the drainage. The primary aim was to report, for the first time in the United States after Food Drug Administration approval of the system, the technical feasibility in the living human. The secondary aim was to report the perioperative outcomes.
The surgeries were successfully completed without conversion. In both cases, the total operative time was 140 minutes. Blood loss was negligible. No complications were recorded. Patients were discharged within 24 hours postoperation.
Herein, we documented the first clinical application of the SP surgical platform for single-port transumbilical robot-assisted radical prostatectomy in the United States. This approach will be further investigated regarding the surgical morbidity and the outcomes.
描述食品药品监督管理局批准后新型专用单孔机器人平台的首次临床经验。
两名被诊断为适合进行根治性前列腺切除术的前列腺癌男性患者,使用达芬奇SP手术系统(直观外科公司,加利福尼亚州桑尼维尔)进行了单孔机器人辅助根治性前列腺切除术及双侧盆腔淋巴结清扫术。手术通过一个2.5厘米的脐周切口完成,通过该切口放置了一个GelPOINT Mini高级接入平台(应用医疗公司,加利福尼亚州兰乔圣玛格丽塔)以及一个专用的25毫米多通道端口,该端口可容纳一个12×10毫米椭圆形关节式机器人摄像头、三个6毫米双关节式机器人器械和一个6毫米辅助腹腔镜器械。一个用于助手的端口放置在直肠旁线水平,即计划的最终引流部位。主要目的是在美国食品药品监督管理局批准该系统后,首次报告在活人身上的技术可行性。次要目的是报告围手术期结果。
手术顺利完成,未中转。两例患者的总手术时间均为140分钟。失血可忽略不计。未记录到并发症。患者术后24小时内出院。
在此,我们记录了SP手术平台在美国用于单孔经脐机器人辅助根治性前列腺切除术的首次临床应用。这种方法将在手术发病率和结果方面进行进一步研究。